Hello again, Bark readers! Welcome back for the second installment of the DIY physical exam. We are going to start at the head today, continuing to move down the dog body over the next couple of weeks.

NOSE:

Normal:

Smooth, soft and clean; it is a misconception that a dry, warm nose means illness; sometimes a normal nose can appear slightly dry as well as warm to the touch; a healthy nose should feel like soft, supple leather; it is not necessarily always cool, wet and moist.

Whites of the eye should not appear colored (such as red or yellow) and should have only a few visible blood vessels.

Pupils should shrink equally when a bright light is shined into either eye and enlarge equally when the eyes are held closed or the room darkened (this is known as a pupillary light reflex and is part of a neurological exam).

Abnormal

Dull, sunken eyes: this can indicate severe dehydration.

Eyes that appear dry and “bloodshot” can indicate conditions such as uveitis, KCS (“dry eye”), severe dehydration, or other systemic illnesses.

Thick discharge from eyes: a little grey “eye booger” in the morning is normal, just like in us people, but be concerned if you notice any discharge with green or yellow color to it.

One or both eyes not centered: this can indicate a tumor or infection behind the eye, as well as other pathology.

Pupils unequal in size: this can indicate head trauma, a possible tumor, other neurologic problems to name a few.

Squinting or tearing of the eyes: this can indicate an ulcer or scratch on the cornea, which is the layer of cells covering the eye.

Abnormal colors that indicate problems are yellow (jaundice), or red (bloodshot); pay close attention to the color of the whites of your pet’s eyes.

The appearance of blood in the eye (known as hyphema): this can indicate exposure to rat bait or other causes of your pet’s blood not being able to properly clot.

Pupils fail to respond, or respond differently from one another, when a bright light is shined into either eye.

EARS:

Chronic ear problems are common in pets, and are often a result of allergies to inhaled pollen (like hay fever in people) that are then complicated by secondary infections with bacteria or yeast. Ear infections can be painful and head shaking can lead to an accumulation of blood in the floppy part of the ear, known as an aural hematoma.

Normal

Skin smooth and without wounds.

Clean and dry.

Almost odor-free.

Typical carriage for breed.

Pain-free when you massage them, especially at the base of the ear.

Abnormal

Wounds, scabs, or any sign of rash.

Crust, moisture, or other discharge in ear canal.

Any strong odor.

Atypical carriage for breed; for example, a droopy ear in a breed with normally erect ears

Painful or swollen ears.

MOUTH:

Normal

Teeth are clean and white.

Gums are uniformly pink and moist to the touch (they should not feel dry or sticky).

Capillary refill time (CRT): to assess, press on the gum tissue with your finger or thumb and then release quickly; the part you just pushed on will turn white, and you will then watch the color return to the gums; this is a crude assessment of how well the heart and circulatory system are working as well as hydration status of you pet; a normal CRT is 1 to 1.5 seconds for the color to return; this can be a difficult test to interpret sometimes (for example, if your pet has dark or pigmented gums), and should not be relied upon as definitive evidence that your pet is sick or healthy.

Abnormal

Tartar accumulation around the base of the teeth.

The gums are red: this can indicate severe dehydration, shock, heat stroke, or sepsis (severe infection in the body).

Gums are bluish or purple: this indicates inadequate oxygen to the body; this can be noted with lung disease, heart disease, or any disease that impairs proper oxygen to the body.

Gums are pale: this is due to lack of blood or shock and possible causes are internal bleeding (such as a mass on a spleen that suddenly ruptures and bleeds- very common in older dogs), trauma or shock (such as when a dog has been hit by a car), and immune mediated diseases.

Gums that appear to have little bruises: this is known as petechiation and is generally seen with rat bait toxicity or other problems with the body’s ability to clot the blood

Gums are inflamed, “spongy” looking, or sore in appearance.

A sluggish CRT, or dry and sticky gums.

That completes the head! Please feel free to ask any questions and see you next week as we discuss and learn about the chest area, known as the thorax. Check out DIY Physical Exam: Part 1[4] of this series if you missed it. Next, DIY Physical Exam: Part 3[5].

Veterinarian Shea Cox has enjoyed an indirect path through her professional life, initially obtaining degrees in fine arts and nursing. She later obtained her veterinary medical degree from Michigan State University in 2001 and has been practicing emergency and critical care medicine solely since that time. In 2006, she joined the ER staff at PETS Referral Center[6] in Berkeley and cannot imagine a more rewarding and fulfilling place to spend her working hours. In her spare time, she loves to paint, wield her green thumb, cook up a storm and sail. Her days are shared with the three loves of her life: her husband Scott and their two Doberman children that curiously occupy opposite ends of the personality spectrum.